中国高原人群体力活动与高血压的关联:基于倾向评分匹配法

Correlation between physical activity and hypertension in Chinese plateau population:Based on propensity score matching

目的探讨倾向评分匹配(PSM)法在体力活动与高血压关联问题的应用,分析我国高原人群体力活动与高血压的关系,为高血压的零级预防提供科学依据。方法选取国家重点研发计划“西南区域自然人群队列”中西藏地区藏族(海拔3 500 m)与丽江地区汉族(海拔2 000 m)人群作为研究对象,通过PSM采用最近邻匹配法进行1∶1匹配,并进行平衡性检验,分析体力活动与高血压的关系。再进一步设定不同的卡钳值、采用逆概率加权法以及针对匹配前的人群进行多因素Logistic回归分析不同体力活动量下人群高血压检出率的差异,进行稳健性分析。结果 PSM后,共纳入8 724名研究对象,匹配成功率为60.3%。SMD>0.1的只有吸烟因素,调整后分析结果显示体力活动充足是高血压的保护因素(OR=0.87,95%CI:0.790.96)。当设置卡钳值为0.1时,家庭收入和饮酒情况未达到平衡,调整后显示体力活动充足是高血压的保护因素(OR=0.89,95%CI:0.800.98);当卡钳值为0.2时,教育程度、体质指数(BMI)、二手烟及高血压家族史未达到平衡,调整后显示体力活动充足是高血压的保护因素(OR=0.83,95%CI:0.750.92)。采用逆概率加权法后组间各协变量均可达到均衡(SMD<0.1),结果支持体力活动充足是高血压的保护因素(OR=0.88,95%CI:0.830.93)。通过对匹配前的研究人群进行Logistic回归分析,调整了其他因素后,结果显示体力活动充足(OR=0.88,95%CI:0.810.96)是高血压的保护因素。结论对于中国高原人群而言,体力活动充足是高血压的保护因素,建议高原地区人群保持充足的体力活动。

ObjectiveTo explore the application of propensity score matching(PSM)in the correlation between physical activity and hypertension,and to analyze the correlation between physical activity and hypertension in Chinese plateau population,so as to provide scientific basis for primordial prevention of hypertension.MethodsThe data of Tibetan(an altitude of 3 500 m)in Tibet and Han(an altitude of 2 000 m)in Lijiang were selected from the National Key R &D Program“Southwest Regional Natural Population Cohort”. The nearest neighbor matching method of PSM was used for 1∶1 matching and balance test was conducted afterwards to analyze the correlation between physical activity and hypertension. In order to perform the robustness analysis,set different caliper values and used the inverse probability weighting method,and the multivariate Logistic regression analysis method was used to analyze the difference of hypertension detection rate under different physical activity in people before matching.Results After PSM,a total of 8 724 participants were included,and the success rate of matching was 60.3%. The only factor with SMD > 0.1 was smoking status,and theresults after adjusting showed that adequate physical activity was a protective factor of hypertension(OR=0.87,95% CI:0.79-0.96). Adjusting the caliper value to 0.1,family income and alcohol drinking status didn’t reach balance,and the re-sults after adjusting showed that adequate physical activity was a protective factor of hypertension(OR=0.89,95% CI:0.80-0.98). Adjusting the caliper value to 0.2,education level,body mass index(BMI),passive smoking and family his-tory of hypertension didn’t reach balance,and the results after adjusting showed that adequate physical activity was a pro-tective factor of hypertension(OR=0.83,95% CI:0.75-0.92). After using the inverse probability weighting method,allthe covariates were in equilibrium(SMD < 0.1),the results supported that adequate physical activity was a protective fac-tor of hypertension(OR=0.88,95% CI:0.83-0.93). After adjusting for other factors,performed Logistic regression anal-ysis on the study population before matching,the results showed that adequate physical activity was a protective factor ofhypertension(OR=0.88,95% CI:0.81-0.96).ConclusionAdequate physical activity is a protective factor of hyperten-sion for Chinese plateau population. It is suggested that people in plateau area should keep adequate physical activity.